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Everything you need to know about Lyme Disease Flare up

Everything you need to know about Lyme Disease Flare up
Lyme disease is a vector-borne illness caused by the spirochete Borrelia burgdorferi. The infection is transmitted from animals to humans by infected black-legged deer ticks. When bitten by the tick, the bacteria enter the bloodstream and spread across the entire body.
An initial Lyme infection causes a series of symptoms for several weeks or months. The symptoms are nonspecific and like those of the flu, such as fatigue, fever, chills, headache, and muscle pain.
Lyme disease is easily cured by a course of antibiotics if discovered and treated early. But if left untreated, the bacteria can attack various parts of your body, including the skin, heart, nerves, and joints.
When the bacteria attack multiple systems, they can evade detection and stay in the body for a long time. This can cause a condition called chronic Lyme disease, also known as post-treatment Lyme disease syndrome (PTLDS). Here, the symptoms last for more than 6 months even after completing the treatment.
Healing from PTLDS isn’t usually a linear process. The recovery involves ups and downs, including occasional flare-ups in between periods of remission. Flare-ups can occur owing to a trigger or as part of the condition.

What are Lyme disease flare-ups?

A sudden exacerbation of inflammatory symptoms associated with Lyme disease is called a flare-up. In this condition, the same symptoms or a worsening of existing symptoms can be experienced. In some cases, patients may also develop new symptoms such as:
  • Increased fatigue
  • Cognitive issues
  • Muscle stiffness and intense pain
  • Poor-quality sleep
  • Dizziness
  • Numbness or tingling in the hands and feet
  • Extreme sensitivity to light
  • Mood changes and irritability
  • Blurred vision
  • Body pain.
It is important to note that every patient will not experience all the above symptoms, as each flare-up case is unique.

What causes Lyme disease flare-ups?

There is no one reason of flare-ups; rather, multiple factors are involved in them. It affects each person differently and at different intensities.
Several theories say that the Borrelia bacterium triggers the onset of other Lyme autoimmune diseases with similar symptoms. Others believe that bacteria can hide in tissues in different parts of the body and can reactivate after some time.
The outburst of Lyme disease symptoms is also linked to co-infections. Research says that co-infections can aggravate the bacteria by modulating the immune system. Co-infections are also considered a leading cause of ineffective treatment. The presence of other infections can cause an increase in inflammation in the body, causing a rise or outburst of symptoms.
According to research, flare-ups are usually caused by physical, mental, or emotional stress. Physical stress-causing factors include:
  • Poor sleep habits
  • Nutritional deficiencies
  • Viral or bacterial infections
  • Surgery or physical injury
  • Hormonal imbalance
  • Menstruation
  • General exhaustion or excessive physical strain
Mental and emotional stress-causing factors include:
  • Grief
  • Anxiety and depression
  • Life stress or stressful events
  • A significant change, such as moving or changing careers
Other factors:
  • Diet high in processed sugars and alcohol
  • Treatment changes
While it is hard or even impossible to prevent specific triggers, there are strategies that may help manage the triggers, which are discussed later in this article.

What do Lyme disease flare-ups feel like?

One of the initial and most common types of flare-ups seen in patients with Lyme disease is the Jarisch–Herxheimer reaction. This is a reaction that occurs when antibiotic therapy is initiated and the body reacts to toxin-like substances released by dying bacteria.
Within 24 hours of starting an antibiotic, the patient experiences worsening of the current symptoms and/or the development of new symptoms. However, the symptoms do not last long. They peak and subside within 24-36 hours.
Other types of flare-ups occur long after treatment, when the patient’s underlying symptoms may reappear or worsen. When someone with PTLDS has a rise in symptoms, it's usually because they haven't received treatment on time.
With the right treatment, most patients fully recover and have no flare-ups. However, in cases of PTLDS, outbursts can occur years after the initial tick bite, even after trying various treatment modalities.

How are Lyme flare-ups treated?

The treatment depends on the underlying cause. If the symptoms occur owing to a persistent infection, the doctor may prescribe a combination of medicines to treat each symptom separately.
1. Combination therapy
The most common treatment used for chronic Lyme disease flare-ups is a combination of antibiotics and anti-inflammatory drugs. It is aimed at treating the individual symptoms of the disease. In many cases, doctors may prescribe painkillers to deal with joint and skeletal pain during flare-ups, along with antidepressants to help deal with the mental and emotional effects of the disease.
Intravenous antibiotics and multivitamins may be given. Infusions offer better and faster recovery, as they directly enter your bloodstream, where bacteria are hiding.
Sleeping pills may also be prescribed by doctors to promote uninterrupted sleep patterns, which can help ease symptoms. They may also recommend lifestyle modifications and stress-relieving activities to promote wellness.
2. Antibiotic therapy
Several studies indicate that Lyme bacteria can survive in a host even after an initial course of antibiotics. Thus, when the symptoms flare up with continued Lyme infections, the doctor may extend antibiotic therapy.
However, long-term antibiotic treatment for Lyme disease has been associated with significant complications. So, if you are considering long-term antibiotic treatment for chronic Lyme disease or PTLDS, consult with your doctor about the risks and benefits.
3. Pulsed electromagnetic field therapy
In a relapse or flare-up, certain things affect the immune system in a way that allows the microbes to thrive. The bacteria can become intolerant of or resistant to antibiotic therapy. Sometimes, nutritional and lifestyle perspectives are not enough to ease your body's inflammatory factors. That is when pulsed electromagnetic field (PEMF) therapy helps in relieving the debilitating symptoms.
Health benefits of PEMF therapy for patients with Lyme disease should also be considered. It is a painless and noninvasive procedure that involves the use of electromagnetic waves to stimulate cells in the areas of the body affected by the illness.
PEMF treatment helps in improving energy levels, reducing pain, and fighting the effects of inflammation, particularly during flare-ups. It may also improve circulation and stimulate the body’s natural healing capacity. Thus, it can help reduce the duration, intensity, and frequency of flare-ups.
PEMF therapy is widely used by chiropractors and other healthcare providers to treat the symptoms of chronic Lyme disease. Here are a few of the advantages of PEMF therapy:
  • Relieves chronic pain
  • Improves joint functionality
  • Increases energy levels
  • Improves sleep
  • Reduces inflammation
  • Stimulates organs
  • Reduces stress and fatigue
  • Supports relaxation
The regular use of PEMF therapy can reduce the severity of Lyme disease flare-ups. Hence, it is recommended by most healthcare providers along with ongoing medications. The benefits of using PEMF in Lyme flare-ups are as follows:
  • Decreases the intensity of symptoms and promotes faster recovery
  • Reduces the chances of chronic Lyme disease
  • Reduces the triggering factors that set off a flare in symptoms
Learn more about PEMF therapy for Lyme disease.

How do you prevent Lyme disease flare-ups?

Because Lyme flare-ups are difficult to treat, the best way to prevent them is to avoid contracting the infection in the first place. This can be done by constantly taking precautions and checking for ticks after spending time in high grass or wooded areas.
If you have already contracted the infection and have been diagnosed with it, getting proper treatment is the best way to deal with it. Manage and prevent Lyme flare-ups by identifying the triggering factors. Keep a log of your daily habits, meals, and emotional health. This might assist you in identifying your triggers.
Here are a few tips to prevent the infection from flaring up:
  • Get early treatment: Early diagnosis and treatment of Lyme can prevent its complications and reduce the risk for flare-ups.
  • Manage stress: High levels of stress can cause damaging effects on various organs, which can cause inflammation. Reduce your stress by practicing stress management techniques such as deep breathing, yoga, meditation, etc.
  • Maintain a healthy lifestyle: Listen to your body when it feels tired and get enough rest or sleep. Taking enough rest will boost your immune system and help you heal from the infection.
  • Avoid sugar consumption: Studies show that high-sugar foods can increase inflammation. Thus, decreasing sugar intake in your diet can reduce the risk for flare-ups.
  • Avoid alcohol consumption as it aggravates the symptoms.
  • Drink plenty of water and keep yourself hydrated.


The majority of patients with Lyme disease have a flare-up at some point during their healing journey. The widespread pain and general feeling of illness can be difficult to cope with.
However, there are certain things you may do to help relieve the symptoms. Listen to your body and identify triggers that set off a flare-up. Triggering factors like stress can compromise the immune system’s ability to keep Lyme disease in check.
Thus, practice self-care and avoid physical, emotional, or any kind of stress. Use a PEMF device to ease your symptoms.
Making these positive changes can reduce the severity of your next flare-up.
  • Berghoff W. Chronic Lyme disease and co-infections: differential diagnosis. Open Neurol J. 2012;6:158-178.
  • Barbour A. Remains if infection. J Clin Invest. 2012;122:2344-2346.